Cervical & Lumbar Patterns

Discogenic LBP – key pattern?

Central LBP ± radiation, deep ache ± sharp, Agg: F/E > LF/Rot, sitting, Ease: extension, standing

Acute lumbar PIV – key pattern?

Unilateral local LBP, sharp severe pain, Agg: open/close joint, sudden onset

Chronic lumbar PIV – key pattern?

Unilateral LBP ± referral, ache + “catch”, worse AM, insidious onset

Postural LBP – key pattern?

Diffuse ache/heaviness, Agg: sustained positions, worse as day progresses

Lumbar Instability – key pattern?

Persistent ache + movement “twinges”, Agg: small loads, Ease: lying, recurrent episodes

Spinal stenosis – key pattern?

Older patient, bilateral leg pain, Agg: walking/extension, Ease: flexion/rest

Acute lumbar radiculopathy – key pattern?

Dermatomal leg pain, severe constant pain, ± sensory/motor deficits

Acute cervical radiculopathy – key pattern?

Neck to arm dermatomal pain, ± pins & needles/weakness, Agg: sustained postures

Chronic cervical radiculopathy – key pattern?

Patchy dermatomal symptoms, less irritable, requires more load to aggravate

Cervical discogenic – key pattern?

Central neck ± medial scapula, Agg: sustained F/E, arm loading, Ease: unloading

Cervical PIV – key pattern?

Unilateral neck ± scapula, sharp (acute) or ache (chronic), Agg: stretch/compress

Cervical postural pain – key pattern?

Widespread neck ache, due to sustained posture, normal ROM

Cervical instability – key pattern?

Persistent ache + twinges, Agg: prolonged positions, poor motor control

Migraine – key pattern?

Unilateral pulsating headache, 4–72 hours, nausea ± photophobia/phonophobia

Tension-type headache – key pattern?

Bilateral tight band, mild–moderate, not aggravated by activity

Cervicogenic headache – key pattern?

Neck-driven headache, Agg: neck movement, reproducible with exam